<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Business_phone')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-business_phone" data-rule="required" class="form-control" name="row[business_phone]" type="text" value="{$row.business_phone}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Business_title')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-business_title" data-rule="required" class="form-control" name="row[business_title]" type="text" value="{$row.business_title}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Link_phone')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-link_phone" data-rule="required" class="form-control" name="row[link_phone]" type="text" value="{$row.link_phone}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Link_man')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-link_man" data-rule="required" class="form-control" name="row[link_man]" type="text" value="{$row.link_man}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Business_address')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-business_address" data-rule="required" class="form-control" name="row[business_address]" type="text" value="{$row.business_address}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Business_img')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-business_img" data-rule="required" class="form-control" name="row[business_img]" type="text" value="{$row.business_img}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Checktime')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-checktime" data-rule="required" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[checktime]" type="text" value="{$row.checktime|datetime}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Refusal_reason')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-refusal_reason" data-rule="required" class="form-control" name="row[refusal_reason]" type="text" value="{$row.refusal_reason}">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
